I’m a physician, part of the enormous all consuming “machine” called modern healthcare. This machine is driven by value based best practice and end results. Literal life and death decisions are required daily, so naturally I become impatient when my son can’t decide between chocolate and vanilla or which movie to watch. My cultivated “Achilles heel” of impatients has a tendency to interfere with daily interactions or decisions because of the dreaded “decision fatigue” that sometimes surfaces as a result of my chosen profession. I’ve wrestled this demon time and time before, not wanting to allow my profession mold my personal interactions. My natural evolution as a physician, husband, and father has included complex searches focusing on areas of self help, personal growth and maturation. I’ve read literally thousands of pages focusing on communication, employee engagement, and managing the patient’s perception. Complex processes have given way to “key words”, 5 step programs, and management initiatives. It’s ironic how in healthcare, we have accomplished so much in the way of cardiac bypass, organ transplant, and early goal directed therapy while neglecting the obvious. We have become so sterile in the area of emotion and empathy, that interactions as innate as sitting at bedside or eye contact have to be taught or scripted. Casual conversation has been replaced by the cold and innovative. I’ve been a victim of this “machine” we call healthcare, and unfortunately I’ve perpetuated the process. In Western society we have become professionals of complication. We create vast processes and complex algorithms, later returning to the obvious and simple calling it “revolutionary or inspiring.” The innovations of the 70’s have been replaced by free range chickens, grass fed cattle, and oxygen therapy. Butter is back in favor over margarine and paleo has replaced many complex processed diets. Healthcare has come full circle, now focusing on patient centered care and communication with less emphasis on the process at hand. Basic human interactions once lost to the machine of innovation have started to resurface, shedding a new encouraging shade of a previous vibrant light. I’m cautiously encouraged about our future at hand, feeling that innate and basic will triumph if not overcome by the “need to innovate or mass replicate.”Through my travels and educational quest to become a physician I’ve been many places. I’ve lived in the center of the world, and trained in highly innovative and cutting edge medical complexes. I’m fortunate to have been exposed to opportunities and experiences that would have seemed impossible when considering my humble beginnings. Ironically it was those long summer days in Southern Arkansas that may have taught me the most. It was on the back of pick up trucks or on the small town square where my education began. It was the life lessons of my father where I learned the value of saying thank you, expressing true empathy, and truly being able to listen and appreciate the words of others. It wasn’t until thirty years later, after being swept up by the ”machine" that I understood the momentous power of simple sincerity and good communication.

Oh how true Dr McWilliams. A smile, kind word, or a tender touch can heal a persons soul, and that is where true healing begins. BACK TO THE BASICs of simply loving those that God places in your path. That is what we are all called to do.

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Jeff

4/12/2016 08:38:02 pm

Thanks Rena. Common courtesy and caring is essential. Punching a time clock can't motivate like a passion for patient care. We continue to treat patients with the highest of our ability and knowledge without neglecting the bedrock of patient care......the patient.

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James Dyer

6/29/2016 02:25:36 am

I want to say thank you for your campassion Dr Jeff i dont know if you remember be your kindness to me as a patient in er may have let me remember the good Doctors out there. You took the time when other sweep ed dx under the rug and you took the time so I could have the right one thank u Dr jeff

In my profession, I was often dismayed by management's pursuit of Buzzwords, Programs and other techniques that mainy served to needlessly complicate issues.
Two examples stand out:
The streets were equipped with gates that could be used to isolate an area if needed. These gates were triangular with the long side on top extended to stretch across the road. We has several incidents of pickup trucks backing into the "spear" of the gate bar. Eventually a gate bar rode up over the truck bed and came through the rear window, nearly spearing the occupant.
An extensive investigation resulted in a new training syllabus to ensure workers would not back into the gates.
My suggestion that we simply turn the gates over so the long edge wouldn't be high enough to ride up into a truck bed was ignored ... Oh, yes the incidents continued admittedly at a lower rate.

In another case, the company initiated a massive "Quality" initiative. Mass meetings, extensive training, new Buzzwords, etc. They even sought to engage our families in the efforts by mailing a "Quality Calendar" to each employee's home. ... February was printed upside down on the calendar.

KISS really works.

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Jeff

4/13/2016 08:28:16 am

Thanks James. Great example. Simple but effective. I find myself often being the guy that over complicates stuff. Sometimes you just need to step back and look at the obvious. Did Annette really crawl over your fence?

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Rayna

4/12/2016 10:29:50 pm

Such simple truths. Kindness is a gift shared by both the giver and receiver.

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Jeff

4/13/2016 08:29:37 am

Thanks Reyna,
Simple kindness is definitely reciprocated. I've had many patient encounters where I felt as helped by them as them by me. Is that grammatically correct?

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Carol

4/13/2016 07:52:30 am

This is a great article! In my 20+ years of nursing I have has the opportunity to see many healthcare providers at work. I have always had the most respect for those that see patients as souls and treat them as such. This is what I look for in a provider for me and my loved ones.

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Jeff

4/13/2016 08:30:59 am

Thanks Carol. I'm with you. Our job foes so much deeper than IVs and vitals. The providers that realize this and stay on task have an internal motivation that will never burn out.

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Keith Byler, D.O.

5/9/2016 11:02:00 am

Great article... and great pic from the doctor series by W.Eugene Smith. Wanted to suggest a contemporary Southern poet to you, James Autry... Check out "Nights Under a Tin Roof," and "Life After Mississippi." Both out of print, but you can likely find on www.abe.com. James went on to become CEO of a Fortune 500 company, but writes simply and eloquently about his upbringing in the rural south in a family of several generations of country pastors. Great stuff.

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jeffrey mcwilliams

5/9/2016 11:52:59 am

Keith,
Thanks for the comment. I really appreciate your feedback and interaction. I will check out James Autry's work without hesitation. This has been my personal journey that I hope can help others to focus on the obvious and the simple.

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Keith Byler, D.O.

5/9/2016 01:29:38 pm

Have you ever run across a book called "Emergency: True Stories From the Nation's E.R.'s"? Fun read... full of pathos, some laughter, etc... Read the entire book in one setting years ago... It's a compilation of stories that this ER doc put together... all true... from ACEP members, ER nurses, medics, etc. A really good read, partly because it speaks to the human element that you're getting at.

I have heard of that book. Sounds like a good one. A few partners and myself have actually discussed righting a similar book related to experiences over the years. I am very fortunate to work with some of the best docs and nurses!

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Keith Byler, D.O.

5/10/2016 08:57:15 am

Being newly retired (April 1st), and a writer by avocation, I have had similar thoughts. I actually have a couple of items in Mark Brown's ER book, and helped him a little with it...I also tend to hang out with author and editor types. If I can be of any assistance, let me know...

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jeff

5/12/2016 07:26:30 am

That sounds great. We should collaborate. I have heard some of the most amazing stories over the years from multiple partners. They would make an outstanding book. How do you get around HIPAA?

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Keith Byler, D.O.

5/12/2016 08:38:46 am

That's a great question, and I can't give a definitive answer... I suspect it would be around "semi-fictionalizing" each vignette, including not mentioning the specific place/institution, changing the age, maybe even the gender... and there could be the rare stories where making those sorts of changes would destroy the efficacy of the thing such that it just can't be used. On the other hand, "There's nothing new under the sun" probably applies most of the time.

It might specifically be a question for Mark Brown, M.D., the guy who put the ER book together... Interestingly, he started his professional life as an attorney, then went to med school, so he might be uniquely qualified to speak to that.

Should we pick this up via email to keep this forum more for its intended purpose? I believe you have mine, even though it's not published... If not, I don't have a big issue putting it up here if needed... let me know.